Toxoplasmosis is a rare parasitic infection. It can also occur during pregnancy and can get transmitted to the unborn baby causing serious health side effects. However, learning how to recognise the symptoms of an infection and timely tests can prevent this disease during pregnancy.
Toxoplasmosis is a parasitic infection caused by an organism called Toxoplasma gondii. The infection causes no obvious symptoms in adults with a healthy immune system and it is estimated that up to half of the world’s population is infected with it at any given time (but show no symptoms.)
In cases that do become apparent, the patient experiences mild flu-like symptoms, tender or inflamed lymph nodes, muscle pains and eye problems. Those with weakened immune system and pregnant women are most prone to catching the infection. In the former, severe symptoms such as poor coordination, confusion, trouble breathing and seizures may occur. In pregnant women, it could lead to a condition called congenital toxoplasmosis that may affect the baby.
You can come in contact with the parasite in various ways , including cat poop, undercooked infected meat, improperly washed utensils used to handle infected meat and drinking contaminated water. The parasite spreads through its cysts that can exist dormant in the surrounding for many months until ingested. Toxoplasmosis can get transmitted from a pregnant mother to her baby but doesn’t get transmitted from a person to person unless there is a case of blood transfusion or organ transplant involved.
Although toxoplasmosis spreads through contaminated meat and water, pet owners who own cats are at the greatest risk of an infection. If you have had cats for a long time, there’s a good chance your body is already immune to the parasite, but getting a new cat during pregnancy increases the risk.
Studies show that chances of toxoplasmosis in pregnancy are very low and about one in 200 women get infected during that period generally, in developed countries. In India however, there is no consensus regarding the rate of toxoplasmosis infections that occur during pregnancy.
In a large number of cases involving healthy adults with strong immunity, there may be no immediate visible symptoms of toxoplasmosis. But if you have gotten infected, the signs would appear after two to three weeks and involve the following symptoms:
Toxoplasmosis infections occur when you unknowingly ingest the cysts of the infection causing parasite through food, water or even by practicing poor hygiene. It is estimated that half of these infections occur from eating raw or undercooked meat that is infected. Lamb, pork and game meat can contain the parasite in their body in the form of tissue cysts that can be infectious if the meat is undercooked. The cysts can also make it into your body when you drink unpasteurized goat milk or cheese, eat unwashed fruits and vegetables or when you touch your nose, mouth or eyes after handling contaminated mediums such as soil, water or cat litter.
Even though all warm blooded animals can contain this parasite, cats are the major host of these disease causing agents. A pet cat owned by a pregnant woman can get infected with the parasite by eating an infected rodent or contaminated meat. The parasites reproduce in their intestines and form ‘oocysts’ which is excreted along with the feces. Kittens are most susceptible to this and can excrete millions of these oocysts over a period of three weeks and in most cases they show no sign of infection. The oocysts turn infectious after 24 hours and can remain infectious up to 18 months. They can contaminate water systems, fruit, vegetables and meat in this period. Therefore handling cat litter or gardening during pregnancy puts you at a high risk of an infection.
Since toxoplasmosis doesn’t cause major problems to most people, there’s no treatment needed if the immune system of the person infected is healthy and strong. For pregnant women however, the chances of transferring the parasite to her baby are fairly high, therefore it is treated with antibiotics. In cases where the unborn baby shows no sign of the infection, i , the doctor might prescribe an antibiotic called Spiramycin. In cases where the baby is infected, the doctor may recommend sulfadiazine and pyrimethamine after the week of pregnancy. Also, in cases where the amniotic fluid is infected and an ultrasound gives a confirmation of a problem, the mother can consult a specialist and also refer to a genetic counselor for further advice. Depending on the gestational age of the baby, termination of the pregnancy is also an option.
Toxoplasmosis infection can be risky to the unborn child. The parasite can travel through the placenta and infect the baby causing a condition called congenital toxoplasmosis. Although it is a rare condition, the risk factor depends mainly on the stage/time at which the mother got infected during her pregnancy. The earlier the infection is contracted and caught , the more severe are its effects on the baby. Miscarriage and still birth are common after effects of congenital toxoplasmosis during early pregnancy as the critical developmental processes occur at this stage. An infection during the second trimester can lead to complications such as:
Most babies that get infected later into the pregnancy are less affected because most of the critical organs have developed and show no obvious symptoms of the infection at birth. They may later develop the symptoms as they grow, and have problems such as:
According to one study in India, about half of the untreated maternal infections are transmitted to the baby. Of those that are transmitted to the foetus, 60 percent do not show symptoms, 30 percent show severe damage and 9 percent of them result in death.
Since the risk of an infection is low, screening for toxoplasmosis is not routine in pregnancies and there needs to be enough symptoms for your doctor to suggest for a screening test. However, when needed, a blood test can detect the presence of an infection by the specific antibodies. The blood test needs to be done at least three weeks after an infection and the antibodies to appear.
If there is a risk that you have been infected during pregnancy, further blood tests can determine how recent it through an IgM antibody count. Increasing levels of IgM antibodies show a recent infection that the body is currently fighting. Decreasing IgM antibodies show that the infection has just subsided. A stable IgM count suggests that you are immune to the infection.
A few simple guidelines when followed can greatly reduce your chances of contracting a toxoplasmosis infection during your pregnancy. Some of them are as follows:
Yes. The parasite can cause congenital toxoplasmosis and impair the fetuses’ development early on during the pregnancy which can result in miscarriages or stillbirth. Signs such as fluid buildup in the brain indicate damage due to the infection and cause mental and motor developmental delays in the baby once it grows up. It can also affect other organs and lead to cerebral palsy and epilepsy.
Yes. Women can breastfeed while having an infection as the possibility of the transmission of the infection is unlikely through breast milk.
Although the chances of getting infected by toxoplasmosis are rare during pregnancy, it’s best to follow precautions to avoid any chances of an infection to stay on the safe side.